Rheumatoid arthritis (RA) is a progressive and chronic debilitating disease. Patients afflicted by RA experience loss of functionality in limbs, increasing pain, and consequent deterioration of health. Lifespan is reduced in individuals with RA. To date, there is no cure for RA. Physiotherapy aims to provide temporary relief from pain, and retard the disability process of the individual.
Physiotherapy for a patient with RA is determined by assessing the following aspects:
• Respiratory function
• Testing muscle strength
• Range of joint motion in limbs (ROM)
• Assessing posture
• Assessing functional capabilities (daily physical activities)
Following are the physiotherapy treatments used for patients with RA:
Electrostimulation
Electrical nerve stimulation has been found to provide therapeutic relief. Stimulation at high frequencies (~70 Hz) can provide relief from pain for nearly 18 hours. It has been observed that daily treatment for 15 mins, or once a week, results in relief from pain after 3 weeks. Postoperative pain, following knee-joint operations, can be treated with electrostimulation. Interfering current stimulation also provides relief from pain. Improved joint movement, reduction in swelling of muscles, and relief from pain are observed with electrostimulation.
Balneotherapy / Hydrotherapy
The use of thermal or mineral water, in treating disease, is termed balneotherapy or hydrotherapy. The potential effects of balneotherapy are still debated. However, patients undergoing balneotherapy observe a marked reduction in joint pain at the time of treatment. Patients are able to perform exercises in a painless manner during the treatment regimen. There are multiple factors that improve the management of pain in individuals with chronic pain conditions. Water reduces 50% to 60% of body weight. The minerals in the water cause tendons, ligaments, and muscles to relax. The body releases acetylcholine (chemical in the nervous system), and endorphins (hormones). This creates a sedatory effect in patients and improves the action of painful joints, respectively. The surrounding environment also plays a significant role in creating a feeling of well being in the patient. The relaxing atmosphere, absence of work duties, a feeling of being on a vacation results in the patient feeling free of the incessant joint-pain.
The main objectives of balneotherapy are to enhance the quality of life of patients, strengthen muscles, improve joint movement, and provide relief from pain in joints. More research needs to be carried out to confirm the therapeutic effects of balneotherapy in the management of arthritis.
